Insurers wary of HIV cover proposal

Insurance companies aren’t at all enthusiastic on the idea of a policy covering the Human Immuno Deficiency Virus (HIV), which leads to the dreaded AIDS infection.

This is despite the Insurance Regulatory and Development Authority (Irda) proposing a mandated cover on this. The companies say there isn’t enough data available to enable them to offer a cover effectively.

“The problem with a cover for HIV patients is that though we are open to it, we need a lot of information to design a policy. Some companies have come up with some limited insurance cover. The industry will still need time to develop a product that satisfies the needs of all customers,” said G Srinivasan, chairman and managing director of New India Assurance.

Early this year, Irda had issued draft guidelines on offering an HIV cover. According to these, the underwriting policy would particularly address individuals who are yet to show symptoms of AIDS and are in stages 1 or 2 of the infection.

“Policy shall indicate an eligibility criteria at the outset to consider the proposal for insurance cover to people living with HIV/AIDS (PLHA). Health insurance cover for PLHA shall not be denied if the eligibility criteria as per the underwriting policy are satisfied,” Irda had said.

K G Krishnamoorthy Rao, managing director and chief executive officer, Future Generali, feels insurers should be allowed to decide to provide such a cover. “We have taken up this issue with Irda, that (it) should be left to the companies to decide whether to offer cover or not, instead of forcing companies to offer cover. One is not sure how many people would be availing this cover. So, pricing such covers will become difficult, without knowing what group he belongs to,” he said.

His company, he added, was not looking, for now, at bringing out a product for HIV patients. "We are still a new company and are looking at basic products to sell. Unless we have sufficient numbers in our basic products, if we start something exotic, the portfolio will go for a toss.”

HDFC ERGO General Insurance has a similar viewpoint. Ritesh Kumar, MD & CEO, said they’d provide a cover on anything for which they could get data. "Insurance is about getting data, so that we can price a product appropriately. Individually, as a company, we wouldn't want to step into an area and then walk out of it. Insurance is about consistence and is a long-term proposition," Kumar said.

He added there were guidelines on confidentiality. "There are several people working in a company. When data comes in, how do you ensure that confidentiality is maintained? If one has to service claims, through in-house or external third party administrators, data needs to be available," he said.

Recently, the National Aids Control Organisation, with representation from the finance ministry and the insurance sector, has set up a working group to accumulate data that would assist in pricing such a product. However, sector experts also feel even if such data might become available, it is still some time before patients could openly come out to procure a cover.

"Though the industry may later come forward and offer such products, patients may not be comfortable with getting a policy. The draft guidelines suggest that patients are supposed to declare before taking a policy that they are HIV-positive. Many would not be willing to make this declaration," said the finance sector head of a global consultancy.